Table 1 Characteristics of the included studies
Author, Year | Country | Prolotherapy group | Control group(s) | Needle | DPT interval | DPT frequency | Sample size | Age (years) Mean | Duration of symptoms Mean | Outcome measures | Follow-ups | Adverse events |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
Kim, 2014 [15] | Korea | Ultrasound-guided injection, 1.5 ml of 20% dextrose + 0.5 ml of 0.5% lidocaine (2 ml of 15% dextrose solution) | Ultrasound-guided injection, 2 ml of autologous PRP (Huons HC-1000 System) | 22-gauge | 2 weeks | 2 | 20 DPT (n = 11) PRP (n = 9) | DPT, 37.8 PRP, 36.2 | DPT, 2.9 y PRP, 2.8 y | FFI | 2 weeks (before the second injection) 10 weeks (2 months after the last injection) 28 weeks (6 months after the last injection) | None |
Ersen, 2018 [14] | Turkey | Ultrasound-guided injection, 3.6 ml of 15% dextrose + 0.4 ml lidocaine (4 ml of 13.5% dextrose solution) | Plantar fascia and Achilles tendon stretching exercises 3 times a week for 3 months + same exercise protocol on their own 3 times/day for the other days | 27-gauge | 3 weeks | 3 | 50 DPT (n = 26) Exercise (n = 24) | DPT, 45.1 Exercise, 46.3 | DPT, 32.8 m Exercise, 34.3 m | VAS, FFI, AOFAS | 21 days 42 days 90 days 360 days | None |
Ugurlar, 2018 [16] | Turkey | Ultrasound-guided injection, 3 ml of 5% dextrose + 1 ml of bupivacaine 5 mg/ml + 6 ml of 0.9% physiologic sodium chloride solution (10 ml of 1.5% dextrose solution) | 1. ESWT, 6 Hz, 2000 pulse, 4 bars 2. PRP, 2 ml prepared by Arthrex ACP Double Syringe System 3. Corticosteroid, 1 ml betamethasone 40 mg/ml + 2 ml bupivacaine 5 mg/ml | Not specified | 1 week | 3 | 158 DPT (n = 40) ESWT (n = 39) PRP (n = 39) Betamethasone (n = 40) | DPT, 37.5 ESWT, 39.2 PRP, 38.4 Betamethasone, 40.1 | DPT, 13.2 m ESWT, 15.7 m PRP, 13.9 m Betamethasone, 14.5 m | VAS, FFI-R | 1 month 3 months 6 months 12 months 24 months 36 months | None |
Umay Atlas, 2018 [13] | Turkey | 3 ml of 15% dextrose + plantar fasciitis exercise treatment | 3 ml of saline + plantar fasciitis exercise treatment | 22-gauge | 3 weeks | 3 | 30 DPT (n = 15) Saline (n = 15) | DPT, 47.06 Saline, 50.60 | DPT, 10.0 m Saline, 11.0 m | VAS, FFI, AOFAS | 3 months (after the first injection) | None |
Mansiz-Kaplan, 2020 [12] | Turkey | 5 ml of 30% dextrose + 4 ml of saline + 1 ml of 2% lidocaine (10 ml of 15% dextrose) | 9 ml of saline + 1 ml of 2% lidocaine | 22-gauge | 3 weeks | 2 | 65 DPT (n = 30) Saline (n = 30) | DPT, 46.7 Saline, 46.2 | Median of 7 m in both groups | VAS, FFI, PF thickness | 7 weeks (1 month after the last injection) 15 weeks (3 months after the last injection) | None |
Asheghan, 2020 [4] | Iran | Ultrasound-guided injection, 2 ml of 20% dextrose | Radial ESWT, 10 Hz, 2000 shock waves, 2 bars (3 sessions, 1 week apart) | 25-gauge | 1 week | 2 | 59 DPT (n = 30) ESWT (n = 29) | DPT, 46.5 ESWT, 43.7 | DPT, 4.5 m ESWT, 4.5 m | VAS, FAAM, PF thickness | 6 weeks (after the first treatment session) 12 weeks (after the first treatment session) | None |
Raissi, 2021 [11] | Iran | Ultrasound-guided injection, 2 ml of 20% dextrose + 1 ml of 1% lidocaine hydrochloride (3 ml of 13.33% dextrose solution) | Ultrasound-guided injection, 1 ml of 40 mg methylprednisolone plus 1 ml of normal saline + 1 ml of 1% lidocaine hydrochloride | 22-gauge | - | 1 | 40 DPT (n = 20) Methylprednisolone (n = 20) | DPT, 50.3 Methylprednisolone, 42.15 |  > 8 weeks | NRS, FAAM, PF thickness | 2 weeks 12 weeks | None |
Kesikburun, 2021 [1] | Turkey | Ultrasound-guided injection, 1.5 ml of 30% dextrose + 1.5 ml of 2% lidocaine (3 ml of 15% dextrose) | Focused ESWT 4–6 Hz, 1800–2000 shock waves + Radial ESWT, 15–21 Hz, 3000–3500 pulses, 1.8–3.0 bars (3 sessions, 2 weeks apart) | 25-gauge | 2 weeks | 3 | 27 DPT (n = 15) ESWT (n = 14) | DPT, 57.4 ESWT, 51.2 | DPT, 12.6 m ESWT, 12.7 m | VAS, FFI | 6 weeks (after the last intervention) 12 weeks (after the intervention) | None |